Factor V inhibitors are a complication of bovine thrombin exposure
It has been reported by Streiff and Ness (Transfusion, Jan., 2002) that Factor V inhibitors are a common complication of bovine thrombin exposure and can have devastating clinical consequences. These authors suggest that transfusion medicine specialists and hematologists can play a critical role in reducing the incidence of Factor V inhibitors by educating the medical community about safer alternative fibrin sealants.
The following replies have been submitted in response to the above.
- Editor's Note: Their report is germane in light of two previous e-network forum discussions:
In addition, the e-network might like knowing that there will be an excellent talk on topical hemostatic agents/sealants on Friday morning April 19, 2002 at the CBBS/SCABB annual meeting in Las Vegas. The speaker will address the issue of acquired coagulation inhibitors. The program organizers encourage everyone to attend the talk and ask the speaker about this subject!
- A blood banker in Los Angeles reports that a pharmacist in her hospital's Drug Information Office has researched the source of the bovine thrombin that is used at her hospital, which is from US cows that are pretested (?) for BSE before the manufacturing process occurs. The responding blood banker did not comment further on how the pretesting for BSE was done. She also reports that the product can be traced back to particular cows!! She adds that the development of Factor V inhibitors after the use of bovine thrombin is of concern, and she asks if anyone knows a source for human thrombin that is manufactured from US plasma donors, rather than from US cows?
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Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator
W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator
Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator
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